慢性肾脏疾病透明质酸变化的观察及其临床意义的探讨

为了探讨透明质酸(hyaluronic acid,HA)任慢性肾脏疾病中的价值,本文采用HA放免分析法,检测了52例慢性肾脏疾病患者血清HA(SHA)及尿HA(UHA)含量,观察厂血液透析(HD)病人HD前后SHA变化,并用健康成年人HA作对比分析,初步探讨了SHA和UHA在慢性肾脏疾病时变化的临床价值。     

喜炎平联合β-内酰胺类抗生素治疗儿童化脓性扁桃体炎观察

探讨喜炎平联合β-内酰胺类抗生素治疗儿童急性化脓性扁桃体炎的临床疗效。将126例儿童急性化脓性扁桃体炎患者随机分为观察组65例与对照组61例。对照组采用β-内酰胺类抗生素治疗,观察组在此基础上加用喜炎平治疗,疗程7～10 d,比较2组的临床疗效。观察组临床症状、体征改善时间明显短于对照组（P＜0.05）,观察组总有效率高于对照组（P＜0.05）;2组患者不良反应发生率无显著性差异（P＞0.05）。喜炎平联合β-内酰胺类抗生素治疗儿童急性化脓性扁桃体炎,可显著缩短病程,提高治疗有效率,使用安全,值得临床推广。     

慢性肾功能衰竭左心室功能变化的观察

左心室收缩时间间期(STI)的测定和超声心动图(UCG)的检查是反映左心室功能的有效手段。本文对24例慢性肾功能衰竭(CRF)患者所做的STI和UCG的结果进行统计分析,并探讨其临床意义。     

脾破裂28例治疗体会

目的:探讨创造性脾破裂的诊断及治疗方法。方法:对28例外伤性脾破裂诊治资料进行分析。结果:28例出现并发症4例,但全部治愈。结论:外伤性脾破裂的诊断,确诊后的损伤分级,是否手术治疗,采取何种手术方法是保证治愈率、降低并发症的关键。     

胆总管探查术中胆总管一期缝合27例报道

目的探讨胆总管探查术中胆总管一期缝合的可行性及临床价值和技术特点。方法回顾分析27例患者应用术中胆道镜进行胆总管探查后行一期缝合情况。结果27例行胆总管一期缝合的患者中胆漏1例，黄疸2例，27例均痊愈。结论胆总管探查术中胆总管一期缝合是安全可行的，但必须注意指征的严格掌握。     

复杂性尿道狭窄的外科治疗

目的 提高复杂性尿道狭窄的治疗效果。方法 复杂性后尿道狭窄采用经会阴或耻骨的尿道端吻合术。复杂性前尿道狭窄采用前尿道劈开,二期尿道成形术。女性尿道闭锁采用双阴唇带蒂皮瓣尿道成形术。结果 ３０例复杂性尿道狭窄手术后,２４例（８０％）排尿通畅,４例（１３％）排尿不畅,２例（７％）失败。结论 开放性手术是复杂性尿道狭窄治疗的首选方法。     

慢性细菌性前列腺炎患者精子中促凋亡蛋白Omi/HtrA2的表达

目的:检测慢性细菌性前列腺炎患者精子中促凋亡蛋白Omi/HtrA2的表达,探讨该疾患影响男性生育的可能机制。方法:采集41例慢性细菌性前列腺炎患者(A组)和12例健康生育男性(B组)的精液后,分别检测精液中炎症细胞因子(TNF-α、IL-1β)的浓度和精子密度、活动力及形态。精液经47.5%、57%、76%和95%Percoll梯度分离法分离后,分别用RT-PCR和Western印迹法检测精子促凋亡蛋白Omi/HtrA2的表达。结果:A组与B组炎症因子TNF-α、IL-1β的浓度分别为:(53.62±27.60)pg/ml、(60.75±32.42)pg/ml和(25.03±5.02)pg/ml、(18.70±7.06)pg/ml,两组相比差异有显著性(P<0.05)。A组中促凋亡蛋白Omi/HtrA2的转录和表达水平亦显著升高(P<0.05)。结论:慢性细菌性前列腺炎患者精子中促凋亡蛋白Omi/HtrA2的表达上调。     

经直肠超声引导下重复穿刺活检在前列腺癌高危人群中的诊断价值(附45例分析)

目的探讨经直肠超声（TRUS）引导下重复穿刺活检在前列腺特异性抗原（PSA）升高或直肠指检阳性的前列腺癌（PCa）可疑人群中的诊断价值。方法在首次穿刺活检诊断为前列腺良性病变的45例Pca高危人群中开展TRUS引导下10点重复穿刺活检。平均年龄78（58-92）岁；45例患者PSA均大于2．6ng／ml，其中12例直肠指检异常。结果在45例前列腺重复穿刺的患者中，34例穿刺2次，8例穿刺3次，3例穿刺4次；确诊Pca 10例（22．2％），良性前列腺增生32例，慢性前列腺炎3例。结论在Pca高危人群中开展TRUS引导下重复穿刺可以提高Pca的诊断率。     

前列腺导管腺癌临床病理和诊治特点分析

Objective To discuss the pathological and clinical features, diagnosis and treatment of prostatic duct adenocareinoma. Methods The clinical data of nine cases of prostatic duct adeno-carcinoma were retrospectively analyzed, with the average age of 76 (59-106) years. Six cases were presented with dysuresia and/or nocturia, and two of them had the painless gross hematuria. Two pa-tients presented painless gross hematuria as the first symptom. One case was detected the elevated ser-um PSA in a routine healthy examination. Radical prostatectomy (RP) was performed in 1 case;RP and bilateral orchidectomy and external beam radiotherapy (EBRT) were performed in 1 case;5 cases underwent transurethral resection of the prostate (TURP) combined with photoselective vaporization of the prostate (PVP) by green laser and bilateral orchidectomy;1 case underwent TURP combined with PVP;1 case underwent bilateral orchidectomy combined with EBRT. Eight cases took flutamide for 3-45 months. All patients were followed-up according to the scheduled time. Results The op-erations were successfully performed in all 9 patients. The papillary or cauliflower-like tumors infiltra-ted colli culus seminalis and prostate duct nearby. The glands were coated with tall pseudostratified columnar cells. The nuclei were large, dark stained with more frequent mitoses. The positive rates of immunolabelling antibody PSA, AR, PAP were found to be 89%(8/9), 100%(5/5), 100%(5/5) re-spectively. The distribution of Gleason score was 6-7(3 cases), and≥8(6 cases), and a coexisting acinar carcinoma component was identified in 5 cases of the group. Nine cases had a mean follow up for 20(3-48) months. Five cases have developed biochemical recurrence, of whom 3 died of bone metas-tasis and multiple organ failure, and 1 developed lung and bone metastasis. Three cases remained alive without recurrence. The remaining 1 case survives during the follow-up survey for 6 months until now, without examinations due to the old age. Conclusions Duct adenocarcinoma of the prostate presents the low incidence and lacks of typical symptoms in the early stage. Diagnosis was confirmed mainly on the basis of pathology. The tumors tend to have a more advanced stage and a very short term survival rate. The treatment options and management are similar to that of high-grade adenocar-cinoma of the prostate;meanwhile, close follow-up survey should be performed.